1.4.14 Children of Alcohol Misusing Parents


In December 2022, a link was added in Further Information to NICE Quality Standard QS 204 Foetal Alcohol Spectrum Disorder.

1. The Child

The effects on children of the misuse of alcohol by one or both parents or carers are complex and may vary in time, which is why a thorough assessment of needs and risk of harm is important. In some cases the misuse of alcohol may be one factor which, when linked to domestic violence and abuse or mental illness, may increase the risks to the child. See also Children of Drug Misusing Parents Procedure and Domestic Abuse Procedure.

The circumstances of children must be carefully assessed not only to consider immediate risks but also the long term effects on the child of their parents' alcohol misuse.

The children of parents who misuse alcohol are at increased risk of developing alcohol problems themselves and of being separated from their parents. Research demonstrates that children who themselves start drinking at an early age are at greater risk of unwanted sexual encounters and injuries through accidents and fighting.

2. Concerns

The health and development of an unborn child may be affected by the parents alcohol misuse and newborn babies may suffer foetal alcohol syndrome which as a result may interfere with the parent/child bonding process. 

Babies may experience a lack of basic health care and poor stimulation and older children may experience poor school attendance, anxiety about their parents' health and taking on a caring role for the parent or siblings.

The parents practical caring skills can be affected by the misuse in the following ways:

  • Lack of attention to basic physical needs;
  • Lack of control of emotions;
  • Impaired judgement.

3. Referrals

Professionals, when confronted with a child in an alcohol-misusing environment must ask themselves "What is it like for a child living in this household?"

An Early Help Assessment will assist in determining the level of vulnerability of the child and at what point a referral is made to Children's Social Care Services - see Referrals Procedure.

4. Assessment and Initial Child Protection Conference

Children's Social Care Services will consider whether it is appropriate to undertake a Single Assessment in relation to all referrals. 

A Single Assessment will consider and take account of whether the person concerned is hiding or denying their alcohol misuse; whether they are engaged in any rehabilitation programme; whether they receive support from a partner, family or friends; the impact of the alcohol misuse on the quality of care given to the child and the day-to-day environment of the child as well as the long term impact on the child.

Throughout the assessment process and where it is decided to call a Strategy Discussion, undertake a Section 47 Enquiry and convene an Initial Child Protection Conference, those agencies who have worked with the parents in relation to their alcohol misuse must be asked to contribute and invited to participate in and attend relevant meetings.

If the concerns are in relation to an unborn child, the maternity services must be invited to attend the Strategy Discussion, and involved in any Section 47 Enquiry, Pre Birth Assessment, Pre Birth Child Protection Conference and, where appropriate, the Core Group.